New onset heart failure — Clinical characteristics and short-term mortality. A RICA (Spanish registry of acute heart failure) study

• Published in: European journal of internal medicine 2015-06, Vol.26 (5), p.357-362
• Main Authors: Franco, Jonathan, Formiga, Francesc, Chivite, David, Manzano, Luis, Carrera, Margarita, Arévalo-Lorido, José Carlos, Epelde, Francisco, Cerqueiro, Jose Manuel, Serrado, Ana, Pérez-Barquero, Manuel Montero
• Format: Article
• Language: English
• Subjects: Acute Disease; Age Factors; Aged; Aged, 80 and over; Chronic Disease; Chronic heart failure; Cohort Studies; Female; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Hospitalization; Humans; Internal Medicine; Male; Mortality; New onset heart failure; Registries; Risk Factors; Spain; Survival Rate; Ventricular Function, Left - physiology
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2015.04.008

Abstract Background Heart failure (HF) is a growing global epidemic. The main study aims is to evaluate the differences between new-onset and chronic-decompensated HF patients. Secondary objectives related only to new-onset HF patients include the role of left ventricular ejection fraction (LVEF) and mid-term mortality related risk factors Methods We analyzed 2190 patients hospitalized for acute HF. We compare the 683 patients with a new-onset HF episode with the rest. Restricting the analysis to the new-onset HF patients, we also compare patients with preserved LVEF (EF > 50%) with those with reduced LVEF, and analyze the factors associated with three-month mortality. Results A total of 683 (31.2%) patients fulfill the criteria for “new-onset HF”. These patients are older, their HF is more often related to hypertension, show higher blood pressure and heart rate values upon admission, and present with less global and disease-specific comorbidity and better baseline overall functional status. New-onset HF is more often characterized by preserved LVEF, milder baseline NYHA class and lower plasma natriuretic peptide values. After 3 months; 33 (5.2%) new-onset HF patients had died (p < 0.001). Cox multivariate analysis showed a correlation between mortality and older age (hazard ratio – HR – 1.08), higher global comorbidity (HR 1.20) and lesser prescription of beta-blockers at discharge (HR 0.34). LVEF was unrelated to mortality. Conclusions New-onset HF patients show a clinical profile different to that of chronic-decompensated patients. For this subset of acute HF patients older age, higher comorbidity and beta-blocker nonprescription predict a higher risk of mid-term post-discharge mortality.